Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report
Abstract Purpose To report our early experience of a novel surgical approach for penile urethral strictures after hypospadias repair, using a lateral incision to keep the ventral tissue and vasculature of the penis intact and to avoid the need for tissue interposition. Patients and methods A total o...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-023-01250-5 |
| _version_ | 1797836248455315456 |
|---|---|
| author | Jianwei Wang Xiao Xu Zhengqing Bao Zhenhua Liu Guizhong Li Feng He |
| author_facet | Jianwei Wang Xiao Xu Zhengqing Bao Zhenhua Liu Guizhong Li Feng He |
| author_sort | Jianwei Wang |
| collection | DOAJ |
| description | Abstract Purpose To report our early experience of a novel surgical approach for penile urethral strictures after hypospadias repair, using a lateral incision to keep the ventral tissue and vasculature of the penis intact and to avoid the need for tissue interposition. Patients and methods A total of 21 patients underwent lateral incision 1-stage urethroplasty with oral mucosal graft. The median age of the patients was 21 years old (range, 13–47). The median number of prior procedures for hypospadias repair was 3 (range, 1–9) with 18 of 21 patients (85.7%) undergoing greater than 1 prior reconstructive procedure. The mean length of the penile urethral strictures was 4.5 ± 1.7 cm, with a range of 1.0 to 8.0 cm. Selection criteria for lateral incision 1-stage urethroplasty include: non-obliterative stricture, no or mild penile curvature and no urethrocutaneous fistula. Results Median follow-up was 30 months (range, 6–73). Success was achieved in 17 of 21 patients (80.9%). The 4 (19.0%) patients with treatment failure developed recurrent urethral strictures. Of the 4 men with recurrent strictures, 3 were ultimately treated successfully by DVIU (2) or two-stage urethroplasty (1), and one patient chose repeated dilation. Conclusions For patients with penile urethral stricture after hypospadias repair with non-obliterative stricture, no significant penile curvature and no urethrocutaneous fistula, a lateral approach with oral mucosal graft is a simple technique that avoids the need for tissue interposition and keeps the penile ventral tissue and vasculature intact, resulting in a low risk of complications. |
| first_indexed | 2024-04-09T15:06:52Z |
| format | Article |
| id | doaj.art-e2bae7c98d764092babfbb2771fc76a7 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-09T15:06:52Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-e2bae7c98d764092babfbb2771fc76a72023-04-30T11:29:36ZengBMCBMC Urology1471-24902023-04-012311610.1186/s12894-023-01250-5Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary reportJianwei Wang0Xiao Xu1Zhengqing Bao2Zhenhua Liu3Guizhong Li4Feng He5Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking UniversityDepartment of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking UniversityDepartment of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking UniversityDepartment of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking UniversityDepartment of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking UniversityDepartment of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking UniversityAbstract Purpose To report our early experience of a novel surgical approach for penile urethral strictures after hypospadias repair, using a lateral incision to keep the ventral tissue and vasculature of the penis intact and to avoid the need for tissue interposition. Patients and methods A total of 21 patients underwent lateral incision 1-stage urethroplasty with oral mucosal graft. The median age of the patients was 21 years old (range, 13–47). The median number of prior procedures for hypospadias repair was 3 (range, 1–9) with 18 of 21 patients (85.7%) undergoing greater than 1 prior reconstructive procedure. The mean length of the penile urethral strictures was 4.5 ± 1.7 cm, with a range of 1.0 to 8.0 cm. Selection criteria for lateral incision 1-stage urethroplasty include: non-obliterative stricture, no or mild penile curvature and no urethrocutaneous fistula. Results Median follow-up was 30 months (range, 6–73). Success was achieved in 17 of 21 patients (80.9%). The 4 (19.0%) patients with treatment failure developed recurrent urethral strictures. Of the 4 men with recurrent strictures, 3 were ultimately treated successfully by DVIU (2) or two-stage urethroplasty (1), and one patient chose repeated dilation. Conclusions For patients with penile urethral stricture after hypospadias repair with non-obliterative stricture, no significant penile curvature and no urethrocutaneous fistula, a lateral approach with oral mucosal graft is a simple technique that avoids the need for tissue interposition and keeps the penile ventral tissue and vasculature intact, resulting in a low risk of complications.https://doi.org/10.1186/s12894-023-01250-5UrethroplastyUrethral strictureUrethral reconstructionStrictures after hypospadiasHypospadias complications |
| spellingShingle | Jianwei Wang Xiao Xu Zhengqing Bao Zhenhua Liu Guizhong Li Feng He Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report BMC Urology Urethroplasty Urethral stricture Urethral reconstruction Strictures after hypospadias Hypospadias complications |
| title | Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report |
| title_full | Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report |
| title_fullStr | Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report |
| title_full_unstemmed | Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report |
| title_short | Lateral incision 1-stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair—a preliminary report |
| title_sort | lateral incision 1 stage urethroplasty with oral mucosal graft for patients with penile urethral stricture after hypospadias repair a preliminary report |
| topic | Urethroplasty Urethral stricture Urethral reconstruction Strictures after hypospadias Hypospadias complications |
| url | https://doi.org/10.1186/s12894-023-01250-5 |
| work_keys_str_mv | AT jianweiwang lateralincision1stageurethroplastywithoralmucosalgraftforpatientswithpenileurethralstrictureafterhypospadiasrepairapreliminaryreport AT xiaoxu lateralincision1stageurethroplastywithoralmucosalgraftforpatientswithpenileurethralstrictureafterhypospadiasrepairapreliminaryreport AT zhengqingbao lateralincision1stageurethroplastywithoralmucosalgraftforpatientswithpenileurethralstrictureafterhypospadiasrepairapreliminaryreport AT zhenhualiu lateralincision1stageurethroplastywithoralmucosalgraftforpatientswithpenileurethralstrictureafterhypospadiasrepairapreliminaryreport AT guizhongli lateralincision1stageurethroplastywithoralmucosalgraftforpatientswithpenileurethralstrictureafterhypospadiasrepairapreliminaryreport AT fenghe lateralincision1stageurethroplastywithoralmucosalgraftforpatientswithpenileurethralstrictureafterhypospadiasrepairapreliminaryreport |